ASR
Alcohol Sales on Reservations
Check if amended
Company name
FEIN
Address
Minnesota tax ID number
City
Period of return
State
Zip
Beer Wine More Less
More Than
More Than
More Than
Sparkling
Cider
Name of Tribe
Than 3.2%
Than 3.2%
14% or Less 14% to 21%
21% to 24%
24%
Wine
(liters)
(in barrels)
(in barrels)
(liters)
(liters)(liters) (liters)(liters) Location code
Distilled Spirits
Bottles
Distilled Spirits Low-Alcohol
Wine & Distilled
(liters, excludingDairyMiniatures Spirits
miniatures)
(liters)(50 ml) (200 ml or more)
Bois Forte Band of Chippewa Indians
Fond Du Lac Reservation
Grand Portage Band of Chippewa
Leech Lake Reservation
Lower Sioux Indian Community
Mille Lacs Band Of Ojibwe Indians
Prairie Island Indian Community
Red Lake Band of Chippewa Indians
Shakopee Mdewakanton Sioux
Community
Upper Sioux Indian Community
White Earth Band of Chippewa Indians
Sign here: I declare that this form is correct and complete to the best of my knowledge and belief.
Authorized signature
Print name
Paid preparer’s signature
Mail to: Minnesota Revenue, Mail Station 3331, St. Paul, MN 55146-3331
Phone: 651-556-3036 TTY: 711 for Minnesota Relay Fax: 651-556-5236 Email: [email protected]
(Rev. 12/12)
Title
Date
Daytime phone
PTIN
Date
Daytime phone
Form ASR Instructions
General Instructions
You must report all alcohol sales made on
Tribal land, including sales made to business that are not owned by the Tribe.
Form ASR is due by the 18th day of each
month, even if you have no sales to report
in any given month.
Wine and Distilled Spirits
Wine and distilled spirits must be reported
in liters.
Bottles
Include on this line all wine and distilled
spirits that are 200 ml or greater in size.
Beer
Note: 3.2% beer is measured by weight, not
by volume.
Conversion Table
The Minnesota tax rate for beer is based
on the 31-gallon barrel and the alcohol
content of beer. You must convert all
measurement of kegs and cases into barrels
or percentages of a barrel.
50 ltr bbl
30 ltr bbl
6/64 oz. case
12/40 oz. case
12/32 oz. case
24/22 oz. case
15/22 oz. case
12/22 oz. case
24/16 oz. case
12/16 oz. case
30/12 oz. case
24/12 oz. case
20/12 oz. case
18/12 oz. case
12/12 oz. case
6/12 oz. case
24/11.2 oz. case
35/7 oz. case
12/21.3 oz. case To convert kegs and cases into barrels,
divide the total ounces of beer in the kegs
or cases by 3,968 (the number of ounces in
a barrel).
1 barrel = 31 gallons
1 gallon = 128 fluid ounces
1 liter = 0.264172 gallons
The conversion table to the right is for the
most commonly used sizes of kegs and
cases. Multiply the number you have of
each size by the decimal shown.
If you have: Multiply the quantity
you have by:
.42608
.25565
.09677
.12097
.09677
.13306
.08317
.06653
.09677
.04839
.09073
.07258
.06048
.05444
.03629
.01815
.06774
.06174
.06441